United States: Senate Sets Timeline To Take Up Repeal And Replace Legislation On ACA

With Congress returning to Washington, D.C. from its Memorial
Day work period, Senators are focusing heavily on the timeline and
details of legislation that would significantly alter the
Affordable Care Act (ACA). Over the last week, many senior Senators
have expressed skepticism regarding whether they can pass a bill,
but Senate Republican Leader Mitch McConnell (R-KY) has laid out an
aggressive timeline. Specifically, he would like the chamber to
vote on a bill before the July 4th recess and use the
rest of July to reconcile the House and Senate versions, leading to
a final vote before the August recess. Congressional Republicans
are eager to move beyond health care in order to take up tax reform
and FY2018 federal government funding.

The Great Medicaid Expansion Divide

Senate Republicans are in agreement that their bill will be
significantly different from what the House passed earlier this
year, but that is where consensus ends. The main sticking point is
how to appease Senators on both sides of the expansion –
states that expanded and those that did not – in order to
cobble together 50 votes (with Vice President Pence delivering the
51st). Those that did expand their Medicaid population
don't want to see their expansion population lose coverage, and
those that did not expand, believe they are entitled to an
additional financial benefit so they are not at a disadvantage as
compared to the expansion states.

Achieving the required savings under reconciliation, while
appeasing both factions, is proving extremely difficult. At this
point, Democrats are not expected to vote for any Senate bill that
significantly modifies the ACA so Republicans must rely entirely on
their own Conference. Senators are also concerned about the
alarming number of Americans projected to lose coverage under the
House passed bill, and are developing a plan that would provide
more generous tax subsidies for purchasing coverage. At this point,
there is very little interest in including changes to the Essential
Health Benefits package as was done in the House bill.

Still Awaiting the House-Passed Bill

In an interesting twist, the Senate parliamentarian is still in
the process of reviewing the House-passed bill to make sure it does
not violate Senate rules. Therefore, the legislative vehicle has
still not officially been delivered to the Senate from the House. A
ruling is expected this week.

Stay tuned for further updates as we eagerly await the first
draft of the Senate bill, which could come as early as this
week.

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On July 25, the U.S. Department of Health and Human Services' Office for Civil Rights (OCR) announced that it has implemented several changes to its web-based breach-reporting portal (commonly referred to as the "Wall of Shame"), which lists healthcare data breaches of 500 or more patient records dating back to 2009.

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